Community Needs Assessment - Survey for TGC Clients Question Title * 1. What is your age group? Under 12 12-17 18-24 25-44 45-64 65+ Question Title * 2. Who are you completing this survey for? Myself My child (0-5) My child (6-12) My teenager (13-17) An adult family member Other (please specify) Question Title * 3. Have you or a family member served in the military? Yes No Question Title * 4. What services do you or your family member receive at The Guidance Center? (Select all that apply.) Therapy / Counseling (talking with a provider to help with mental health or substance use concerns) Case Management (help connecting to housing, benefits, healthcare, or other supports) Medication Management (prescribing and monitoring medications for mental health conditions) Crisis Services (immediate help during a mental health or substance use crisis) School-Based Services (mental health support provided through schools) Family & Early Childhood Services (support for families and young children) Community Support Services (CSS) (help with daily living skills and independence) Care Coordination (help managing care across providers and services) Peer Support (support from someone with lived experience) Psychiatric Rehabilitation (skill-building to support recovery and daily functioning) Employment / Supported Employment (help finding and keeping a job) Other (please specify) Question Title * 5. Which TGC location(s) do you typically visit? (select all that apply) Leavenworth Atchison Jefferson County / Oskaloosa School-Based Guiding Lights Crisis Center Other (please specify) Question Title * 6. On a scale of 1-4, how was your experience scheduling your first appointment with us? 1=Very Difficult 2=Difficult 3=Easy/Convenient 4=Fast, very easy, highly convenient 1=Very Difficult 2=Difficult 3=Easy/Convenient 4=Fast, very easy, highly convenient Please share your thoughts on how we can improve appointment scheduling: Question Title * 7. Which appointment times are most convenient for you? (select all that apply) Monday-Friday 7:00 AM – 12:00 PM (Morning) Monday-Friday 12:00 PM – 4:00 PM (Afternoon) Monday-Friday 4:00 PM – 8:00 PM (Evening) Saturday 8:00 AM – 12:00 PM (Morning) Saturday 12:00 PM – 4:00 PM (Afternoon) Saturday 4:00 PM – 7:00 PM (Evening) Question Title * 8. How do you usually travel to appointments? Personal vehicle Ride from someone RideLV or other public transportation The Guidance Center van/shuttle On foot/by bicycle (walking/bike-riding) I often have trouble getting transportation Question Title * 9. How and where would you prefer to receive services? (select all that apply) TGC Main Office – Leavenworth TGC Office – Atchison TGC Office – Oskaloosa (Jefferson County) School-Based Setting (e.g., at your child’s school) Community-Based Setting (e.g., local health department, clinic, coffee shop, park) Online - Telehealth In-home visit Other (please specify) Page1 / 2 50% of survey complete. Next